The Concept of CMR

Dyslipidemia

Besides glucose, various plasma lipid variables also play a role in increasing CVD risk. The regulation of lipoprotein and vascular physiology appears to be related to normal insulin sensitivity. Insulin resistance is associated with the typical dyslipidemic profile seen in patients with type 2 diabetes. This profile is characterized by increased levels of fasting triglycerides, low levels of HDL cholesterol, and elevated concentrations of small, dense LDL, which is the most atherogenic component of LDL cholesterol (16). Results from a recent study revealed that in coronary patients with type 2 diabetes, the low HDL cholesterol/high triglycerides pattern correlates with the prevalence of coronary artery disease and significantly predicts the incidence of vascular events, but the LDL-related factor does not (17). It is generally accepted based on data from numerous studies that high triglyceride-low HDL cholesterol dyslipidemia is an independent risk factor for CVD among people with diabetes (18). Accordingly, three intervention trials have shown improvement in CVD risk with successful treatment of diabetes-related dyslipidemia (19).